| NPI | 1235244260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SADAF BAHADORAN Pharmacy Manager 949-642-8057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2019-04-05 |